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Background: Medial epicondyle fractures may occur in isolation or with associated elbow dislocation. In the absence of open fracture or fragment incarceration, nonoperative management with immobilization has been shown to result in generally successfully outcomes comparable with those reported after surgical fixation. However, no comparative investigation has assessed outcomes after nonoperative treatment based on the presence or absence of elbow dislocation.

Methods: A systematic review was conducted investigating all studies in the literature reporting nonoperative outcomes for isolated medial epicondyle fractures and fracture-dislocations. Databases included in this review were PubMed, Biosis Preview, SPORTDiscus, PEDro, and EMBASE. We sought to evaluate results related to the incidence and outcomes of bony nonunion and the incidence of elbow stiffness, pain, ulnar neuropathy, cubitus valgus deformity, and laxity between isolated fractures of the medial epicondyle and fracture-dislocations.

Conclusions: In the absence of absolute surgical indication, nonoperative management of isolated medical epicondyle fractures with or without concomitant elbow dislocation seems to be successful with few long-term complications leading to functional disability. However, increased rates of nonunion, elbow stiffness, and elbow laxity may occur with fracture-dislocations, and merit further study with validated functional outcome scores. Further comparative studies are necessary to determine the true indications and outcomes in nonoperatively managed medial epicondyle fractures.

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​The Pediatric Orthopaedic Society of North America (POSNA)is a group of healthcare professionals, primarily pediatric orthopaedic surgeons, dedicated to advancing musculoskeletal care of children and adolescents. JPO is our official member journal. Like us on facebook and become a member today!